Operation that captured world's imagination

01 December 2017 - 07:55 By AFP
MEDICAL BREAKTHROUGH: A tableau of the world's first heart transplant -  with silicon mannequins representing Christiaan Barnard and his team, and the heart recipient, Louis Washkansky. Some of the original equipment used by Barnard has been included in the tableau at the Heart of Cape Town Museum, in the city's Groote Schuur Hospital.
MEDICAL BREAKTHROUGH: A tableau of the world's first heart transplant - with silicon mannequins representing Christiaan Barnard and his team, and the heart recipient, Louis Washkansky. Some of the original equipment used by Barnard has been included in the tableau at the Heart of Cape Town Museum, in the city's Groote Schuur Hospital.
Image: Rodger Bosch/AFP

It was an operation that earned him acclaim, but the world's first heart transplant also provoked hate mail and outspoken criticism of South African surgeon Christiaan Barnard 50 years ago.

"We did not realise that it would take the public by storm and create such an outcry," says Dene Friedmann, a specialist nurse on the cardiovascular team, standing in the same Cape Town operating theatre where the medical feat took place.

"There were people who wrote quite critical letters to Professor Barnard, horrible letters calling him 'the butcher'," says Friedmann, now in her seventies.

The French magazine Paris Match summed up the ethical debate in a headline: "The battle of the heart. Do surgeons have the right?"

But the scientific community welcomed the technical advance and ordinary citizens sent congratulations.

At the time the heart was not considered a mere organ - it was more a symbol of deeper meaning, for some, the bringer and taker of life itself.

Unlike today, there was no common legal definition of brain death and the surgical team did not want to be accused of removing a beating heart to give it to another human.

There was also a political dimension, with South Africa's apartheid government delighted to have some good news.

"They used Professor Barnard as the ambassador for the country," recalls Friedmann.

It was on the first floor of Groote Schuur Hospital on December 3 1967 that Louis Washkansky received the donor heart of Denise Darvall, the 25-year-old victim of a road accident.

Darvall's father had agreed to the procedure. In the operating theatre Friedmann leaned in to assess Washkansky on the table.

"I looked into this empty chest with no heart in it, a man lying there without a heart in his body and just a lung heart machine keeping him alive. It was very scary," she says.

In the room next door, Barnard ordered that Darvall's ventilator be turned off. After about 12 minutes her heart stopped beating and it was quickly moved to the theatre where 53-year-old Washkansky awaited it.

Barnard, then 45, said of the operation: "The heart lay paralysed, without any sign of life. We waited - it seemed like hours - until it slowly began to relax. Then it came like a bolt of light.

"There was a sudden contraction of the atria, followed quickly by the ventricles in obedient response. Little by little it began to roll with the lovely rhythm of life."

Today about 3,500 transplants are carried out each year. About 88% of patients survive the first year after surgery, 75% survive for five years and 56% 10 years after the operation.

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